diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/JsonParser.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/JsonParser.java
index 2b7a6fa8f4c..f4b3b3eca45 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/JsonParser.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/JsonParser.java
@@ -26,6 +26,7 @@ import ca.uhn.fhir.model.api.*;
 import ca.uhn.fhir.model.api.annotation.Child;
 import ca.uhn.fhir.model.base.composite.BaseCodingDt;
 import ca.uhn.fhir.model.base.composite.BaseContainedDt;
+import ca.uhn.fhir.model.base.composite.BaseResourceReferenceDt;
 import ca.uhn.fhir.model.primitive.IdDt;
 import ca.uhn.fhir.model.primitive.InstantDt;
 import ca.uhn.fhir.narrative.INarrativeGenerator;
@@ -736,8 +737,18 @@ public class JsonParser extends BaseParser implements IJsonLikeParser {
 			}
 			theEventWriter.beginObject();
 			writeOptionalTagWithTextNode(theEventWriter, "url", extension.getUrl());
-			String extensionDatatype = myContext.getRuntimeChildUndeclaredExtensionDefinition().getChildNameByDatatype(extension.getValue().getClass());
-			writeOptionalTagWithTextNode(theEventWriter, extensionDatatype, extension.getValueAsPrimitive());
+			RuntimeChildUndeclaredExtensionDefinition runtimeDefinitions = myContext.getRuntimeChildUndeclaredExtensionDefinition();
+
+			String extensionDatatype = runtimeDefinitions.getChildNameByDatatype(extension.getValue().getClass());
+			if (extension.getValue() instanceof IPrimitiveDatatype) {
+				writeOptionalTagWithTextNode(theEventWriter, extensionDatatype, extension.getValueAsPrimitive());
+			} else {
+				if (extension.getValue() instanceof BaseResourceReferenceDt) {
+					writeOptionalTagWithTextNode(theEventWriter, extensionDatatype, ((BaseResourceReferenceDt) extension.getValue()).getReference());
+				} else {
+					throw new IllegalArgumentException("Cannot parse meta extension with type: " + extension.getValue().getClass().getSimpleName());
+				}
+			}
 			theEventWriter.endObject();
 		}
 		theEventWriter.endArray();
diff --git a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/ParserState.java b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/ParserState.java
index fab95e21059..194e026cde3 100644
--- a/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/ParserState.java
+++ b/hapi-fhir-base/src/main/java/ca/uhn/fhir/parser/ParserState.java
@@ -489,6 +489,8 @@ class ParserState<T> {
 				}
 			} else if ("url".equals(theName) && myInstance instanceof ExtensionDt) {
 				((ExtensionDt) myInstance).setUrl(theValue);
+			} else if ("value".equals(theName) && myInstance instanceof BaseResourceReferenceDt) {
+				((BaseResourceReferenceDt) myInstance).setReference(new IdDt(theValue));
 			} else {
 				if (myJsonMode) {
 					myErrorHandler.incorrectJsonType(null, myElementName, ValueType.OBJECT, null, ValueType.SCALAR, ScalarType.STRING);
diff --git a/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2Test.java b/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2Test.java
index 324d44341b8..f3f9595a988 100644
--- a/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2Test.java
+++ b/hapi-fhir-structures-dstu2/src/test/java/ca/uhn/fhir/parser/JsonParserDstu2Test.java
@@ -22,7 +22,9 @@ import java.io.IOException;
 import java.io.StringReader;
 import java.util.*;
 
+import ca.uhn.fhir.model.base.composite.BaseResourceReferenceDt;
 import org.apache.commons.io.IOUtils;
+import org.hamcrest.CoreMatchers;
 import org.hamcrest.Matchers;
 import org.hl7.fhir.instance.model.api.IIdType;
 import org.junit.AfterClass;
@@ -1719,6 +1721,12 @@ public class JsonParserDstu2Test {
 		addExtensionResourceMetadataKeyToResource(procedureRequest, true, "http://someurl.com/modifier", "SomeValue");
 		addExtensionResourceMetadataKeyToResource(procedureRequest, true, "http://someurl.com/modifier2", "SomeValue2");
 
+		Organization organization = new Organization();
+		organization.setId(new IdDt("Someorganization"));
+		ExtensionDt extensionDt = new ExtensionDt(false, "http://someurl3.com", new ResourceReferenceDt(organization.getId()));
+		procedureRequest.getResourceMetadata()
+			.put(new ResourceMetadataKeyEnum.ExtensionResourceMetadataKey(extensionDt.getUrl()), extensionDt);
+
 		String json = ourCtx.newJsonParser().encodeResourceToString(procedureRequest);
 
 		// @formatter:off
@@ -1741,6 +1749,33 @@ public class JsonParserDstu2Test {
 		// @formatter:on
 	}
 
+	@Test
+	public void testParseResourceWithReferenceExtensionMetadata() throws Exception {
+		String input = IOUtils.toString(getClass().getResourceAsStream("/procedure-request.json"));
+		IParser parser = ourCtx.newJsonParser();
+		IParserErrorHandler peh = mock(IParserErrorHandler.class);
+		parser.setParserErrorHandler(peh);
+
+		ProcedureRequest p = parser.parseResource(ProcedureRequest.class, input);
+
+		ArgumentCaptor<String> capt = ArgumentCaptor.forClass(String.class);
+		verify(peh, Mockito.never()).unknownElement(Mockito.isNull(IParseLocation.class), capt.capture());
+		assertReferenceExtensionMetadata(p, "http://someurl3.com", false, ResourceReferenceDt.class, "dc0b549a-f852-11e6-bc64-92361f002671");
+	}
+
+	private void assertReferenceExtensionMetadata(
+		BaseResource resource,
+		String url,
+		boolean isModifier,
+		Class<?> expectedType,
+		String expectedValue) {
+		ExtensionDt extension = (ExtensionDt) resource.getResourceMetadata().get(new ResourceMetadataKeyEnum.ExtensionResourceMetadataKey(url));
+		assertThat(extension.getValue(), CoreMatchers.instanceOf(expectedType));
+		assertThat(extension.isModifier(), equalTo(isModifier));
+		assertThat(extension.getValue(), CoreMatchers.instanceOf(BaseResourceReferenceDt.class));
+		assertThat(((BaseResourceReferenceDt)extension.getValue()).getReference().getIdPart(), equalTo(expectedValue));
+	}
+
 	@Test(expected = IllegalArgumentException.class)
 	public void testCannotEncodeSubextensionsOnMeta() {
 		ProcedureRequest procedureRequest = new ProcedureRequest();
diff --git a/hapi-fhir-structures-dstu2/src/test/resources/procedure-request.json b/hapi-fhir-structures-dstu2/src/test/resources/procedure-request.json
new file mode 100644
index 00000000000..ed498db91aa
--- /dev/null
+++ b/hapi-fhir-structures-dstu2/src/test/resources/procedure-request.json
@@ -0,0 +1,12 @@
+{
+	"resourceType": "ProcedureRequest",
+	"meta": {
+		"extension": [
+			{
+				"url": "http://someurl3.com",
+				"valueReference": "Organization/dc0b549a-f852-11e6-bc64-92361f002671"
+			}
+		]
+	},
+	"status": "accepted"
+}